1. Potential Costs and Benefits of Incorporating PGT-A Across Age Groups: A Canadian Clinic Perspective.
- Author
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Davis OS, Favetta LA, Deniz S, Faghih M, Amin S, Karnis M, and Neal MS
- Subjects
- Humans, Female, Adult, Retrospective Studies, Fertilization in Vitro economics, Age Factors, Canada, Pregnancy, Genetic Testing economics, Sperm Injections, Intracytoplasmic economics, Preimplantation Diagnosis economics, Aneuploidy, Cost-Benefit Analysis
- Abstract
Objective: To assess the potential costs and benefits of preimplantation genetic testing for aneuploidy (PGT-A) across age groups, considering financial costs, total euploidy rates and the potential for morphology grading to predict a euploid embryo., Methods: This study is a blinded retrospective chart review of patients who incorporated PGT-A as part of their in vitro fertilization (IVF) treatment cycle at a university-affiliated fertility clinic. Patients between 25-44 years of age undergoing IVF with intracytoplasmic sperm injection and PGT-A with autologous oocytes (n = 220) were included in this study. Number of blastocysts achieved, euploidy rates and PGT-A costs were compared between 3 age groups: <35 years, 35-37, and ≥38. Additionally, agreement on the top-quality embryo based on morphology assessment alone versus PGT-A selection was analyzed and further compared based on the number of blastocysts achieved., Results: A significant negative correlation between patient age and number of embryos produced, PGT-A costs, and euploidy rates (P < 0.001) was observed. Additionally, morphology alone ratings were able to predict the top-quality euploid embryo 78% of the time in the <35 age group, but only 32% of the time in the ≥38 age group (P < 0.05), with a trend toward even lower agreement when 3 or fewer blastocysts were produced., Conclusion: Based on our cost analysis, it may be advantageous to incorporate PGT-A when maternal age is ≥38, given the lower financial costs associated with each cycle and the low likelihood of transferring a euploid embryo on the first attempt for this age group. Nevertheless, we acknowledge that PGT-A remains a complex decision influenced by a multitude of factors., (Copyright © 2024 The Author. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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